Missed POPs
The missed pill rules for the progestogen only pill (POP) are simpler than those used for the combined oral contraceptive pill, but it is important not to confuse the two.
| 'Traditional' POPs (Micronor, Noriday, Nogeston, Femulen) |
Cerazette (desogestrel) |
| If less than 3 hours late |
|
| • no action required, continue as normal |
|
| If more than 3 hours late (i.e. more than 27 hours since the last pill was taken) |
|
| • action needed - see below |
If less than 12 hours late |
| • no action required, continue as normal |
|
| If more than 12 hours late (i.e. more than 36 hours since the last pill was taken) |
|
| • action needed - see below |
|
Action required, if needed:
- take the missed pill as soon as possible. If more than one pill has been missed just take one pill. Take the next pill at the usual time, which may mean taking two pills in one day
- continue with rest of pack
- extra precautions (e.g. condoms) should be used until pill taking has been re-established for 48 hours
Missed COCs
The advice from the Faculty of Sexual and Reproductive Healthcare (FSRH) has changed over recent years. The following recommendations are now made for women taken a combined oral contraceptive (COC) pill containing 30-35 micrograms of ethinylestradiol
If 1 pill is missed (at any time in the cycle)
- take the last pill even if it means taking two pills in one day and then continue taking pills daily, one each day
- no additional contraceptive protection needed
If 2 or more pills missed
- take the last pill even if it means taking two pills in one day, leave any earlier missed pills and then continue taking pills daily, one each day
- the women should use condoms or abstain from sex until she has taken pills for 7 days in a row. FSRH: 'This advice may be overcautious in the second and third weeks, but the advice is a backup in the event that further pills are missed'
- if pills are missed in week 1 (Days 1-7): emergency contraception should be considered if she had unprotected sex in the pill-free interval or in week 1
- if pills are missed in week 2 (Days 8-14): after seven consecutive days of taking the COC there is no need for emergency contraception*
- if pills are missed in week 3 (Days 15-21): she should finish the pills in her current pack and start a new pack the next day; thus omitting the pill free interval